Nearly 10 months into a “ceasefire” in the Gaza Strip, as Israel on Tuesday killed at least one Palestinian man with an airstrike on the Nuseirat refugee camp, Doctors Without Borders declared that “the wounds of war are not only unhealed—they are still being inflicted.”

“This is not a ceasefire,” said the medical charity, also known as Médecins Sans Frontières (MSF), in a statement. “It is a continuation of the genocide, calibrated to be violent enough to keep Palestinians suffering every day, yet silent enough to avoid stirring international outrage.”

Israeli forces have killed more than 73,300 Palestinians in Gaza and wounded over 174,009 since the Hamas-led October 7, 2023 attack on Israel—with global experts warning the true toll is likely far higher. Local authorities have documented at least 1,200 deaths and 3,900 injuries since the ceasefire was agreed to over nine months ago.

Experts with the United Nations and others around the world have denounced the Israeli assault and blockade as a genocide, and South Africa is leading a related case at the International Court of Justice. The International Criminal Court has also issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and his former defense minister, Yoav Gallant, over the mass slaughter.

Nearly all of Gaza’s roughly 2 million survivors have been forcibly displaced, starved, or sickened. MSF said that “the destruction of homes has not stopped with the announcement of the ceasefire. Sudden and arbitrary orders for people to flee their homes and shelters continue to be used as a tool of psychological warfare by Israeli forces.”

Rajaa Jendiya, who was widowed in the “flour massacres,” is living in a tent at a school-turned-displacement camp with her children. She told Middle East Eye that she often takes them to the hospital because of illnesses.

“Inside and around the school, you often see sewage water overflowing, while rubbish accumulates, attracting flies and insects,” Jendiya said. “These conditions become even worse with the heat, and many times my children have developed skin diseases.”

In such makeshift shelters across Gaza, “scabies, respiratory infections, rat bites, and other diseases are rife,” according to MSF.

Accessing healthcare has also become difficult in the coastal strip, as Israel has killed and detained Palestinian medical providers, and bombed civilian infrastructure such as hospitals, including in the months since the ceasefire deal was reached.

As MSF detailed Tuesday:

On July 16, an Israeli strike near an MSF clinic in Al-Mawasi sent four injured people to our teams. The following day, two apartment buildings housing our staff in Gaza City were struck without warning, trapping families inside as explosions shattered windows. In one building, rubble and bodies crashed into the lower-floor apartment of an MSF staff member.

The same day, MSF teams in Deir al-Balah, central Gaza, treated 12 people—seven of whom were children—who were injured after Israeli forces struck a funeral in Al-Nuseirat. In total, this strike killed eight people and injured 20. Among those killed was the 21-year-old son of an MSF staff member. Our colleague got the news while working in another emergency room.

“These were not isolated incidents,” the organization stressed, “but merely a snapshot of 48 hours in Gaza.”

Israel has also limited the flow of food and medicine into the war-torn territory. Calling out the country for using humanitarian assistance “as an instrument of oppression,” MSF emphasized that “the Israeli state has an obligation under international law to ensure Palestinians in Gaza have access to aid, regardless of political negotiations, military agreements, or conduct of hostilities.”

Since October, when the Israel Defense Forces controlled about half of Gaza, the “yellow line” indicating IDF occupation has kept shifting, to push Palestinians into “an ever-shrinking area,” MSF explained. “Today, almost 2 million Palestinians are confined to approximately 30% of the strip.”

After speaking with residents in Deir al-Balah, Khan Younis, Rafah, and Gaza City’s Zeitoun, Tuffah, and Shejaia neighborhoods, Reuters reported Tuesday that “Israeli forces have advanced the yellow block markers during the past ⁠10 days, triggering new waves of displacement in areas already devastated by months of conflict.”

While loading bags and mattresses onto a truck in Zeitoun, Assem Dawla told the news agency: “The whole war is displacement, displacement. You can’t stay anywhere without [Israel] telling you, ‘Get out of here, we want to come in.’”

Staying near the yellow line comes with risks. MSF said that “just this week, one mother told our teams that her 14-year-old son, who has Down syndrome, was shot five times by Israeli snipers near the yellow line while he was playing near his home.”

“A ceasefire should ensure that hostilities are paused, weapons are silenced, and that people are safe from strikes across the strip,” the group asserted. “Using it as a weapon of war and reinforcing the confinement to a fraction of Gaza cannot be justified.”

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